| NPI | 1235486705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2018016511) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 036138486) | 
| Enumeration Date | 2012-08-14 | 
| Last Update Date | 2022-10-05 |